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BAYBORO PHARMACY
CH04102J GREENE COUNTY HEALTH CARE, INCORPORATED
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Covered Entity Details
Entity Name
GREENE COUNTY HEALTH CARE, INCORPORATED
Subdivision Name
Pamlico Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH04102J
Entity Address
313 MAIN ST
BAYBORO, NC 28515-9529
Grant Number
H80CS00088
Participating Start Date
4/1/2012
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
BAYBORO PHARMACY
Pharmacy Address
702 MAIN ST
PO BOX 176
BAYBORO, NC 28515-9634
Pharmacy Comments
Contract Details
Approval Date
3/20/2012
Contract Begin Date
4/1/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Beverly Stroud, CFO
(252) 747-8162 Ext: 204
Contract Pharmacy Representative
Bayboro Pharmacy
Lori Altman, Owner
(252) 745-5539
Signed By Date
3/5/2012
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